About half of very low birth weight (VLBW) infants (<1500 g at birth) require blood transfusions to manage anemia. To better understand how to improve RBC transfusion efficacy and reduce their transfusion burden, researchers conducted a retrospective cohort study using the Recipient Epidemiology Donor Evaluation Study III (REDS III) database. The study examined the associations of donor, component, and recipient factors on transfusion effectiveness following one or more single RBC transfusions in 254 VLBW infants (median birth weight, 860 g; median gestational age, 25 weeks; 40% female). Although variability was limited for component characteristics (e.g., median storage duration, 11 days; IQR, 8-16), component characteristics did not affect post-transfusion hemoglobin increments. Lower post-transfusion hemoglobin increments from RBC units were associated with female donors (-0.24 g/dL, p=0.04) and any donor <25 years of age as compared to donors >46 years of age (-0.57 g/dL, p=0.02). In addition, VLBW infants transfused with RBC units from male donors with reduced hemoglobin were associated with increased need for another transfusion (odds ratio, 3.0; 95% C.I., 1.3 to 6.7). Further studies are needed to explore the mechanistic aspects of these findings.
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